System and method for managing insurance accounts in response to leave data

ABSTRACT

A computer system includes a data storage device including a database containing data for insurance policies covering individuals, a communication device to exchange data with an employer&#39;s computer system, and a processor in communication with the data storage device and communication device. A non-transitory storage medium stores program instructions operative with the processor to receive an eligibility data file including data for individuals covered by personal insurance; transmit to the employer computer system a bill file including payroll deductions data for the insurance premiums; receive from the employer computer system a remit file including actual payroll deductions made data and individual leave status data; determine which individuals are on leave based on a verification of an insurance payment; adjust and store data indicative of the premiums associated with individuals determined on leave; and transmit to the employer a payroll deduction modification request for individuals determined to be on the leave.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of co-pending U.S. patentapplication No. 12/951,594 entitled System and Method for ManagingElectronic Accounts in Response to Disability Data, filed Nov. 22, 2010,the entire contents of which are herein incorporated by reference forall purposes.

FIELD OF THE INVENTION

The present invention relates to computer systems used in connectionwith insurance operations.

BACKGROUND

Many insurance policies are written directly to the individualpolicyholders;

personal automobile insurance policies, homeowner's insurance policiesand individual term and whole life insurance policies typically fallinto this category. In other cases, insurance that personally benefitsindividuals may be provided in connection with group policiesestablished as the result of cooperation between the insurance companyand the employer of the covered individuals. Group life insurancepolicies and/or long term disability insurance coverage—often partiallyor entirely subsidized by the employer—are a typical example of thelatter type of insurance policy. In some cases, there can be extensionsto the relationship established between the insurer and the employees ofa company that established a group insurance policy. For example,employees may sign up for individual, personal automobile insurancecoverage and/or homeowner's coverage through a group program madeavailable by their employer, with premiums paid to the insurer viadeductions from the employees' pay.

The present inventors now disclose an improved method and system forincreasing the attractiveness of employer-based insurance plans thatpersonally benefit a company's employees and without burdening theemployer.

SUMMARY

An apparatus, method, computer system and computer-readable data storagemedium are disclosed which include storing a database in a data storagedevice, where the database contains data relating to a number ofinsurance policies that cover insured individuals.

The apparatus, method, computer system and computer-readable datastorage medium further include receiving, via an input device, data thatindicates the employment status for certain ones of the insuredindividuals.

Still further, the apparatus, method, computer system andcomputer-readable data storage medium include adjusting, by use of acomputer, data indicative one or more attributes of the insurancepolicies in response to the data that indicated the individuals'employment status.

In one application of the invention, the data indicates that some of theindividuals are in a status such that they are disabled and on leavefrom work. In response to this data, the computer may reduce or suspendthe individuals' obligation to pay premiums on personal automobileinsurance or homeowner's policies. This policy feature may be providedas part of a group program in which personal auto or homeowner'sinsurance is made available via the individuals' employer, and may makethe group program more attractive than programs offered by competinginsurance companies.

With these and other advantages and features of the invention that willbecome hereinafter apparent, the invention may be more clearlyunderstood by reference to the following detailed description of theinvention, the appended claims, and the drawings attached hereto.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 schematically illustrates an environment in which the presentinvention may be applied.

FIG. 2 is a block diagram that illustrates a computer system provided inaccordance with aspects of the present invention.

FIG. 3 is a block diagram that illustrates a server computer that is acomponent of the computer system of FIG. 2.

FIG. 4 is a block diagram of a typical personal computer that may beused by an insurance company billing analyst in the system of FIG. 2.

FIGS. 5A and 5B together form a flow chart that illustrates a processthat may be performed in accordance with aspects of the invention in thesystem of FIG. 2.

FIG. 6 shows an example screen display that may be provided to a user bythe system of FIG. 2.

FIGS. 7A and 7B together form a flow chart that illustrates analternative process that may be performed in accordance with aspects ofthe invention in the system of FIG. 2.

FIG. 8 graphically illustrates an exchange of data files that may occurbetween an insurance company and an employer in the system of FIG. 2.

DETAILED DESCRIPTION

In general, and for the purposes of introducing concepts of embodimentsof the present invention, a computer system to administrate an insurancepolicy—such as a personal automobile insurance policy or a homeowner'sinsurance policy—may provide that the policyholder's obligation to paypremiums may be reduced or waived during periods when the policyholderis on a disability leave from his/her employment. This system featuremay be particularly applicable to situations in which the coverage ispaid for via payroll deductions in connection with a group program madeavailable by the policyholder's employer. Automatic exchange of databetween the employer and the insurance company may help to alert theinsurance company of the occurrence of disability leave status forpolicyholders and may prompt the insurance company to waive or reducepremiums in those cases.

FIG. 1 schematically shows aspects of an insurance business. As iscustomary, the insurance company in question operates one or morecentral computers, including server computer 102 shown in FIG. 1. Othercomputers deployed in the insurance company may includepersonal/notebook computers assigned to individual employees, includingthe computer indicated by reference numeral 104. One function that maybe performed by the computer 104 is displaying data 106 that has beendownloaded to the computer 104 from the server computer 102 via acommunication path 108.

The server computer 102 may also exchange information with otherparties, including for example employers that make available groupinsurance programs issued by the insurance company. This exchange ofinformation may occur via private and/or public data communicationnetworks, including the Internet (reference numeral 110). Such plansmay, for example, provide homeowner's coverage for employees who areowners of residential properties 112; or may provide personal automobileinsurance coverage for employees who are owners of motor vehicles 114.The employees may work in a factory 116 or other facility operated bytheir employer.

Still further, the insurance company may have contractual or otherrelationships with numerous independent insurance agencies that placeand provide services for policies written by the insurance company. Thusthe server computer 102 may engage in data communication with computers118 operated by the company's agents. As indicated at 120, the insuranceagent computer 118 includes a screen display by which the agent can viewinformation downloaded to the insurance agent computer 118 from theinsurance company server computer 102.

FIG. 2 is a block diagram that illustrates a computer system 200provided in accordance with aspects of the present invention.

Block 202 in FIG. 2 represents a server computer that is part of thecomputer system 200. The computer 202 may be operated by an insurancecompany for the purposes of performing administrative functions relativeto insurance policies issued by the insurance company. (For example, thecomputer 202—which may hereinafter be referred to as the “policyadministration server computer”—may correspond to the computer 102 shownin FIG. 1).

Reference numeral 203 in FIG. 2 represents the Internet or other publicor private data communications network. The policy administration servercomputer 202 may be coupled to the data communication network 203, toallow the policy administration server computer 202 to communicate withother components of the system 200.

The computer system 200, as depicted in FIG. 2, may also include apersonal computer 206. The personal computer may be assigned to abilling analyst employee of the insurance company and may be coupled tothe data communication network 203. For example, the personal computermay be operated by the billing analyst and interact via the datacommunication network 203 with the policy administration server computer202. (Although only one personal computer 206 is shown in the drawing,in practice the system 200 may include numerous computers of this kind.The personal computer 206 may hereinafter be referred to as a “billinganalyst computer”).

In addition, the computer system 200 may include a server computer 208that is operated by an employer of individuals covered under a groupinsurance program offered by the insurance company. The computer 208 maybe operated in connection with functions relating to the employer'spayroll operations. The computer 208 may also be coupled to the datacommunication network 203 to permit data communication between thecomputer 208 and one or more other components of the system 200.

Also shown in FIG. 2 is a personal computer 210 that is owned by anindividual policyholder employed by the employer that operates thecomputer 208. The policyholder computer 210 may be coupled to the datacommunication network 203, and may for example receive electronicnotices transmitted from time to time by the policy administrationserver computer 202.

FIG. 3 is a block diagram representation of the policy administrationserver computer 202. The policy administration server computer 202 maybe conventional in terms of its hardware aspects.

As depicted in FIG. 3, the policy administration server computer 202includes a processing module 302, which may be constituted by one ormore conventional computer processors. The policy administration servercomputer 202 may also incorporate a policy administration module 304.The policy administration module 304 may operate in many respects in aconventional manner, but may also implement aspects of the presentinvention, as described herein. The policy administration module 304 maybe implemented at least in part in conjunction with the processingmodule 302 in combination with suitable software program instructions.

The policy administration server computer 202 further includes a premiumadjustment module 306. The premium adjustment module 306 may operate,with other components of the policy administration server computer 202and/or of the system 200, to reduce or waive personal insurance policypremiums for individual policyholders who are on a disability leavestatus with their employer, in accordance with principles of the presentinvention. The premium adjustment module 306 may be constituted, atleast in part, by the processing module 302 in combination with suitablesoftware program instructions. Aspects of the software programinstructions for the premium adjustment module 306 will be describedbelow.

Still further, the policy administration server computer 202 includesone or more storage devices, represented by item 308 in FIG. 3. Thestorage devices 308 are coupled for data communication with theprocessing module 302 and may comprise any appropriate informationstorage device, including combinations of magnetic storage devices(e.g., magnetic tape and hard disk drives), optical storage devices,and/or semiconductor memory devices (such as Random Access Memory (RAM)devices and Read Only Memory (ROM) devices). At least some of thesedevices may be considered computer-readable storage media, or mayinclude such media. The storage devices 308 may store theabove-mentioned software program instructions and/or other programinstructions to control the processing module 302 such that the policyadministration server computer 202 provides desired functionality, asdescribed herein. Thus, the storage devices 308 store one or moreprograms for controlling the processing module 302. The processingmodule 302 performs instructions of the programs, and thereby operatesin accordance with aspects of the present invention. In someembodiments, the programs may include one or more conventional operatingsystems. The programs may further include application programs such as aconventional data communication program and a conventional databasemanagement program. The programs stored in the storage devices 308 mayalso include conventional web hosting software.

The storage devices 308 may also store one or more databases, includingfor example a database (not separately shown) that contains insurancepolicy data for a universe of insurance policies, including policieswith premium reduction and/or premium waiver riders, as described below.

Continuing to refer to FIG. 3, the policy administration server computer202 may further include one or more communication devices 310 coupled tothe processing module 302. The communication devices 310 may function tofacilitate communication with, for example, other devices (such as theemployer computer 208—FIG. 2, or the billing analyst computer 206). Assuch, the communication devices 310 may also serve as input devices inthe sense that the communication devices 310 may allow for input of datafrom other devices into the policy administration server computer 202.For example, the communication devices 310 may receive data files fromemployers that offer group insurance programs, as described below.

In addition, the policy administration server computer 202 may includeone or more input devices 312 such as a keyboard, a keypad, a mouse orother pointing device, a microphone, knob or a switch, an infra-red (IR)port, a docking station and/or a touch screen. The input device(s) 312may be coupled to the processing module 302.

Still further the policy administration server computer 202 may includeone or more output devices 314, such as a display (e.g., a displayscreen), a speaker, and/or a printer. The output devices 314 may also becoupled to the processing module 302.

FIG. 4 is a block diagram representation of a typical embodiment of thebilling analyst computer 206 shown in FIG. 2. The billing analystcomputer 206 may be conventional in terms of its hardware aspects. Thebilling analyst computer 206 may also be essentially conventional in itssoftware aspects, except that via a browser it may provide functionalityin accordance with aspects of the present invention as disclosed herein.

As depicted in FIG. 4, the billing analyst computer 206 includes a databus 401. The billing analyst computer 206 also includes a computerprocessor (CPU) 400 which is operatively coupled to the data bus 401 andwhich may be constituted by one or more conventional processors. Thebilling analyst computer 206 further includes a network interface unit402, system memory 403, one or more storage devices 404, and aninput/output controller 406, all of which are also operatively coupledto the data bus 401.

The network interface unit 402 may function to facilitate communicationwith, for example, other devices (such as the policy administrationserver computer 202). The input/output controller 406 may couple thebilling analyst computer 206 to input and output devices (not shown)such as a keyboard, a keypad, a mouse or other pointing device, amicrophone, knob or a switch, an infra-red (IR) port, a docking station,a touch screen, a display (e.g., a display screen), a speaker, and/or aprinter. The display and/or input devices are represented by block 407and may, e.g., include a flat panel display or other display device forpresenting screen displays to the user of the billing analyst computer206.

The system memory 403 may be constituted by, for example, a suitablecombination of Random Access Memory (RAM) devices 408 and Read OnlyMemory (ROM) devices 410.

Storage devices 404 may comprise any appropriate information storagedevice, including combinations of magnetic storage devices (e.g.,magnetic tape and hard disk drives), optical storage devices, and/orsemiconductor memory devices. At least some of these devices (and/or allor part of the system memory 403) may be considered computer-readablestorage media, or may include such media.

Storage devices 404 store one or more programs (at least some of whichbeing indicated by blocks 412, 414) for controlling CPU 400. CPU 400performs instructions of the programs, and thereby operates inaccordance with aspects of the present invention. In some embodiments,the programs may include one or more conventional operating systems,indicated by block 414 in FIG. 4. The programs may further includeapplication programs (block 412) such as a conventional datacommunication program and a conventional browser. The applicationprograms 412 may, for example, include a conventional electronic mailprogram and a conventional database management program.

There may also be stored in the storage devices 404 other software, suchas device drivers, etc.

Still further, the storage devices 404 may store one or more databases(block 416) for storing and managing the data relating to operation ofthe billing analyst computer 206.

FIGS. 5A and 5B together form a flow chart that illustrates a processthat may be performed in accordance with aspects of the invention in thesystem 200.

At 502 in FIG. 5A, the insurance company receives a request foradjustment of the premium for personal insurance coverage provided to anemployee of a corporation (the “employer”) that makes available to itsemployees a group program offered by the insurance company. Theinsurance company may receive the request from the employer. The reasonfor the employer submitting the request may be that the employee hasjust been placed on leave from his/her employment because he/she isdisabled from working. The request may, in some embodiments, relate topersonal automobile insurance coverage provided to the insured/employeeby the insurance company. The insurance coverage may contain a riderthat provides that the insured individual's premiums will be reduced(e.g., partially waived) by a predetermined amount during periods inwhich the insured is disabled. The request submitted at 502 may be forreduction of the employee's personal automobile insurance premiumpursuant to the rider.

The insurance company may offer this rider at no charge as an additionalattractive feature of the group program offered through the employer. Inunderwriting terms, it may make good business sense for the insurancecompany to offer this rider because on average it is likely that theemployee will tend to drive his/her automobile less during a period ofdisability. For example, a large part of the use of the automobiletypically may have been for commuting to work, which will not occurduring the period of disability. Alternatively, there may be a chargefor the rider.

Referring again to FIG. 5A, at 504 information is gathered to assemble afile relative to the request received at 502. This may occurautomatically via the policy administration server computer 202 and/ormay represent activities undertaken by a billing analyst to whom therequest is assigned. This may involve gathering various file componentsrelated to the request, including information about the insuredindividual and the individual's enrollment history.

FIG. 6 shows an example screen display that may be provided to a user(e.g., an insured individual) to initiate the process of FIGS. 5A/5B.The screen display of FIG. 6 may be provided to the insured individualvia the display component of the insured individual's computer 210 shownin FIG. 2. For example, this screen display may be downloaded from thepolicy administration server computer 202 to the insured individual'scomputer 210 via the browser in the insured individual's computer 210.

At 506, the billing analyst may perform a review as to whether theinsured individual is entitled to the requested reduction in premium.For example, the billing analyst may determine whether the insuredindividual falls into a class of insureds who are eligible for premiumreduction, whether the insured individual was properly enrolled underthe premium reduction rider, whether the insured individual meets anyapplicable age limit, and whether the insured individual's personalautomobile insurance policy was in force as of the last day theindividual worked before entering his/her disability leave.

Following block 506 is a decision block 508. At decision block 508, itis determined whether the individual insured is eligible for a premiumreduction under the rider. This determination may be made, for example,based on the information gathered and considered at 504 and 506. If apositive determination is made at decision block 508 (i.e., if it isdetermined that the insured individual is eligible for a premiumreduction), then the process of FIGS. 5A and 5B advances from decisionblock 508 to block 510. At block 510, the billing analyst verifies thatthe rider covers the insured individual. In addition, the billinganalyst may obtain medical information concerning the insuredindividual.

Decision block 512 follows block 510. At decision block 512, it isdetermined whether the insured individual is totally disabled (i.e., isunable to perform any work, whether full-time or part-time). If apositive determination is made at decision block 512 (i.e., if it isdetermined that the insured individual is totally disabled), then theprocess of FIGS. 5A and 5B advances from decision block 512 in FIG. 5Ato block 514 in FIG. 5B.

At block 514, the request for premium reduction is approved and therequest file is entered into a diary file forreconsideration/re-certification after a predetermined period of timehas elapsed.

In some embodiments, the review of the request for premium reductionand/or the reconsideration/re-certification may include verifying thatthe insured individual is in fact receiving payments under his/herdisability insurance coverage. In this way, the process forconsidering/reconsidering the premium reduction may rely on thedisability claim processing outcome arrived at by the disabilitycoverage provider. In some embodiments, the disability coverage providermay be a different insurance company from the insurer that is providingthe personal automobile coverage. In this case, the policyadministration server computer 202 may engage in an automatic exchangeof information with a computer operated by the disability coverageprovider to determine whether the insured individual's disability claimis being paid. There may be a similar exchange of information even in acase where the auto insurer is also the disability insurer, if aseparate computer from the policy administration server computer 202 isadministrating disability claim handling. In addition or alternatively,the policy administration server computer 202 may receive informationabout disability status or claim payments from a payroll servicescontractor retained by the employer of the insured individual, or fromthe insured individual himself/herself.

In some embodiments, the premium reduction/waiver may be applied for nomore than a limited period of time, say six months or one year.

In some embodiments, reconsideration/re-certification may includedetermining whether a scheduled ending date for the disability statushas arrived, and then terminating the premium reduction/waiver if thatdate has arrived.

In some embodiments, if the insured individual's employment terminates,the disability status and the premium reduction/waiver may alsoterminate.

Block 516 follows block 514. At block 516, notification that the requestfor premium reduction has been approved is sent out. This may be done byeither or both of electronic mail and postal mail, and may involvesending the notification to either or both of the insured individual andthe employer. If the approval notification to the insured individual isin electronic form, it may prompt the insured individual to provideinput (e.g., by clicking a virtual “verify” button) to verify his/herdisability status.

Block 518 follows block 516. At block 518, suitable data isentered/stored in the policy administration server computer 202 suchthat the premium reduction is implemented for the insured individual'spersonal automobile insurance coverage. In some cases this may result ina reduction of the amounts of future bills for the premium, and/or in apartial refund to the insured individual of premium amounts alreadypaid.

If the insured individual has been paying for the premium by deductionsfrom the individual's pay, then block 520 may follow block 518 in FIG.5B. At block 520 the policy administration server computer 202 may takeaction to change the deduction activity relative to the individual'spay. For example, the individual may no longer receive a paycheck whilehe/she is on disability leave, so that deductions for premium paymentsfor the individual's personal automobile insurance coverage may beinterrupted, and the policy administration server computer 202 mayproceed with billing the individual directly for the reduced premium. Insome embodiments, if the individual has paid in advance for the premiumthat is subject to reduction, then the individual may receive a creditagainst future premiums or a refund to reflect the amount of thereduction.

Referring again to decision block 508 in FIG. 5A, if a negativedetermination is made at that decision block (i.e., if it is determinedthat the insured individual is not eligible for a premium reduction),then the process may advance from decision block 508 to block 522 inFIG. 5A. At block 522, the request for a premium reduction is denied.Then, block 524 follows block 522. At block 524, the insurance companysends out a notification that the premium reduction is denied. As in thecase of block 516, the notification may be by electronic mail and/orpostal mail, and may be sent to the employer and/or the insuredindividual.

Referring again to decision block 512 in FIG. 5A, if a negativedetermination is made at that decision block (i.e., if it is determinedthat the insured individual is not totally disabled), then the processmay advance from decision block 512 to blocks 522 and 524 as describedin the previous paragraph.

In the process of FIGS. 5A and 5B, actions described therein, includingactions performed by the billing analyst, may in some embodiments be atleast partially performed automatically by a computer such as the policyadministration server computer 202. This may be done, for example, by asoftware-programmed expert system that has been designed to gather,assess and make determinations concerning, premium reduction requestfiles. In other words, in some embodiments, the process of FIGS. 5A and5B may be partially or entirely automated.

FIGS. 7A and 7B together form a flow chart that illustrates analternative process that may be performed in accordance with aspects ofthe invention in the system 200. One possible difference between therespective processes of FIGS. 5A/5B and of FIGS. 7A/7B is that in thelatter, the insurance company may automatically generate a premiumreduction request for the insured/disabled individual based on reportsof new disability benefit claims received by the insurance company fromthe employer. That is, in the process of FIGS. 7A/7B, the insurancecompany may itself initiate the premium reduction process instead of theprocess being initiated by a request submitted by the employer as in theprocess of FIGS. 5A and 5B.

Turning then to FIG. 7A, at 702, the insurance company (e.g., via thepolicy administration server computer 202) may automatically parse thereport of disability claims received from the employer and may generatepremium reduction requests for each newly disabled employee who appearsin the disability claim report. For each premium reduction request sogenerated, block 704 may follow block 702. At 704 the new premiumreduction request is entered into the request handling system andassigned to a billing analyst.

Block 706 (eligibility review) then follows block 704. Block 706 may besubstantially the same as block 506 as described above in connectionwith FIG. 5A.

Block 708 then follows block 706. At block 708, for example, the billinganalyst may review the insured individual's disability claim file, andmay request further information if needed based on the review of thedisability claim file.

Decision block 710 follows block 708 in the process of FIGS. 7A and 7B.Decision block 710 may be the same as decision block 508 as describedabove in connection with FIG. 5A. If a positive determination is made atdecision block 710, the process of FIGS. 7A/7B may advance from decisionblock 710 to block 712. Block 712 may be the same as the block 510described above in connection with FIG. 5A.

In some cases, block 714 may follow block 712 in the process of FIGS.

7A/7B. At block 714, the billing analyst may, if appropriate, reviewdocumentation prepared by the medical case manager for the insuredindividual's disability case. If necessary the billing analyst mayconsult with the medical case manager to determine the insuredindividual's functional limitations.

In the process of FIGS. 7A/7B, decision block 716 may follow block 712or 714, as the case may be. Decision block 716 may be the same as thedecision block 512 described above in connection with FIG. 5A. If apositive determination is made at decision block 716, then blocks 718,720, 722 and 724 (all shown in FIG. 7B) may follow decision block 716.Blocks 718-724 may be the same as the blocks 514-520 as described abovein connection with FIG. 5B.

Referring again to decision block 710 in FIG. 7A, if a negativedetermination is made at that decision block, then blocks 726 and 728 inFIG. 7A may follow decision block 710. Blocks 726 and 728 may be thesame as the blocks 522 and 524 as described above in connection withFIG. 5A.

Referring again to decision block 716 in FIG. 7A, if a negativedetermination is made at that decision block, then blocks 726 and 728may follow decision block 716.

As was the case with the process of FIGS. 5A/5B, in the process of FIGS.7A/7B, some or all of the activities that are performed in someimplementations by the billing analyst may alternatively be automated inother implementations.

One advantage of the process of FIGS. 7A/7B is that the premiumreduction/waiver program may be implemented without imposing any burdenon, or requiring any changes in procedure by, the employer of theinsured individual.

FIG. 8 graphically illustrates an exchange of data files that may occurbetween an insurance company and an employer in the system 200. Thisexchange of data may underlie the automated generation of premiumreduction requests as in the process of FIGS. 7A/7B.

At 802, an “eligibility” data file is transmitted from the employer tothe insurance company. This may be done at regular intervals, such asweekly. This file may originate from the internal payroll department oroutside payroll administrator for the employer. (As indicated at 804, apayroll consolidation contractor may be an intermediary for one or moreof the data exchanges between the employer and the insurance company).

The eligibility data file 802 may include employee identificationinformation/ID numbers as well as the names and addresses of theemployees. The payroll cycle applicable to each employee may also beidentified. The file may verify the employees' status as employees atthe time of the effectiveness of a group insurance program and/or at thetime of renewal of such a program. The eligibility data file 802 mayalso provide background for a prospective payroll deduction for theemployees.

At 806, the insurance company transmits a “bill” file to the employer. Apurpose of the bill file 806 is to request payroll deductions fromemployees' pay to fund premium payments by the employees for insurancecoverage provided by the insurance company. For example, the premiumsdeducted from the employees' pay may be for either or both of personalautomobile insurance and homeowner's insurance. For each relevantemployee, the insurance company calculates the appropriate amount of thededuction and inserts that amount in the bill file 806. The insurancecompany sends the bill file 806 at an appropriate time before the nextpayroll cycle to which the file 806 pertains. A separate bill file maybe sent for each payroll cycle that is in effect for the employer (e.g.,weekly, semi-monthly and/or monthly payroll cycles).

At 808, the employer transmits a “remit” file to the insurance company.This may be done shortly after each payroll cycle and may reflect thedeductions made from the employees' pay in the payroll cycle. Inparticular, the remit file may include the employee identificationnumbers, amounts deducted and a status code for each employee. Thestatus code may, for example, indicate whether the employee is on adisability leave of absence or on another type of leave. From thesecodes (e.g., from a change in status to “on disability”), the policyadministration server computer 202 may initiate premium reductionrequests, as described in connection with FIGS. 7A and 7B. In addition,the insurance company may post the remitted deduction amounts as premiumpayments, and may look into any discrepancies with the employer.

In the above discussion of FIGS. 5A, 5B, 7A and 7B, a premium reductionrider was described. Alternatively, however, a rider may be provided tocompletely waive the premium during periods in which the insured is ondisability leave. In some embodiments, there may be a separate chargefor this rider.

The above description discusses premium reduction or waiver with respectto premiums for personal automobile insurance coverage. In addition oralternatively, such a premium reduction or waiver rider may be appliedto one or more of homeowner's insurance, renter's insurance, condoinsurance, umbrella liability policies, motorcycle insurance, boatinsurance, golf cart insurance, snowmobile insurance and offroad vehicleinsurance. It may be feasible to provide a premium waiver rider withoutcharge for homeowner's insurance premiums, if studies show that thepresence of disabled insured individuals at their homes may tend toreduce the frequency and/or severity of claims due to burglary, fire,water damage, etc.

The operation of premium reduction or waiver riders has been describedin the context of group plans, including those paid for by payrolldeductions. However, premium reduction or waiver riders may also beapplied, in accordance with the invention, to personal automobile and/orhomeowner's policies that are billed directly to the insured and/orwhich are not provided through group programs.

In embodiments described above, the premium for an insurance policy wasreduced or waived for periods when the insured was on disability leave.In addition or alternatively, other policy terms besides the premium duemay be modified in case the insured is disabled. For example, the policyliability limit and/or deductibles may be raised or lowered in suchcircumstances. As used in the present disclosure and the pending claims,the term “attribute” as applied to an insurance policy includes thepremiums charged, before or after any waiver or reduction, and otherpolicy terms such as liability limit or deductibles.

Above-described embodiments have provided that policy terms, such as theamount of premium due, may be modified for periods when the insured ison disability leave. However, the same may alternatively occur duringother periods of absence from work, such as maternity or paternityleave. In some embodiments, the insurance policy term modification mayapply only for periods when the insured is confined to a hospital orrehabilitation facility. In some embodiments, the insurance policy termmodification may apply only to certain types of injuries and/orillnesses.

In some embodiments, a GPS tracking device or the like may be installedon the insured individual's car to confirm that usage of the coveredvehicle is actually decreased. In the event that the usage does notdecrease, the premium reduction or waiver may be withdrawn.

Where disability claims or status are referred to herein, the same maybe long-term disability or short-term disability. In some embodiments,the amount of premium reduction/waiver or other change in attributes ofthe insurance policy may depend on whether the disability status is longterm or short term. More generally, the type and/or degree of policyattribute adjustment, if any, may depend on the type of change inemployment status.

Processes portrayed herein as being performed by one computer may inpractice be divided among two or more computers. Processes portrayedherein as being performed by two or more computers may in practice beperformed by a single computer. The process descriptions and flow chartscontained herein should not be considered to imply a fixed order forperforming process steps. Rather, process steps may be performed in anyorder that is practicable.

As used herein and in the appended claims, the term “adjusting” includesany change in an attribute of an insurance policy or in data thatrepresents the attribute.

As used herein and in the appended claims, the term “computer” refers toa single computer or to two or more computers in communication with eachother and/or operated by a single organization or by two or moreorganizations that are partly or entirely under common ownership and/orcontrol.

As used herein and in the appended claims, the term “processor” refersto one processor or two or more processors that are in communicationwith each other.

As used herein and in the appended claims, the term “memory” refers toone, two or more memory and/or data storage devices.

The present invention has been described in terms of several embodimentssolely for the purpose of illustration. Persons skilled in the art willrecognize from this description that the invention is not limited to theembodiments described, but may be practiced with modifications andalterations limited only by the spirit and scope of the appended claims.

What is claimed is:
 1. A computer system for processing data relating toan insurance premium adjustment program, the system comprising: a datastorage device that stores a database, the database containing datarelating to a plurality of personal insurance policies that coverindividuals; a communication device configured to exchange data with acomputer system of an employer having individual employees who arecovered by at least one of the plurality of personal insurance policies;a processor in communication with the data storage device and thecommunication device; and a non-transitory storage medium incommunication with the processor and storing program instructions, theprocessor operative with the program instructions to: receive via thecommunication device according to a pre-determined schedule aneligibility data file including data relating to the individualsemployed by the employer covered by at least one of the plurality ofpersonal insurance policies; transmit to the employer computer systemvia the communication device a bill file based on the eligibility file,the bill file including data indicative of payroll deductions to be madefrom individual payroll amounts to fund insurance premiums for each ofthe individuals covered by at least one of the plurality of insurancepolicies; receive from the employer computer system via thecommunication device a remit file, the remit file including dataindicative of the payroll deductions actually made from the individualpayroll amounts to fund the insurance premiums for each of theindividuals covered by at least one of the plurality of insurancepolicies and leave status data for each of the individuals covered by atleast one of the plurality of insurance policies; determine, responsiveto receipt of the remit file, which of the individuals are on a leave,the determination made based on a verification of whether an insurancepayment has been made to the individuals for whom the leave status datais indicative of the individual being on the leave; adjust, responsiveto a determination of a leave, data indicative of the insurance premiumsassociated with the personal insurance policies of the individualsdetermined to be on the leave; storing the adjusted data indicative ofthe insurance premiums in the database; and transmit to the employer viathe communication device a payroll deduction modification request forthe individuals determined to be on the leave.
 2. The computer system ofclaim 1, wherein the leave comprises a disability leave.
 3. The computersystem of claim 2, wherein adjusting data indicative of premiumscomprises adjusting the data based on whether the disability leave is ashort-term disability leave or a long-term disability leave.
 4. Thecomputer system of claim 1, wherein the leave comprises one of amaternity leave, a paternity leave, a hospital confinement leave, and arehabilitation facility leave.
 5. The computer system of claim 1,wherein the leave is associated with a specific injury.
 6. The computersystem of claim 1, wherein the processor is further operative with theprogram instructions to terminate adjustment of the data indicative ofthe insurance premiums for an individual when the eligibility data fileindicates that employment of the individual has been terminated.
 7. Thecomputer system of claim 1, wherein the processor is further operativewith the program instructions to adjust the data indicative of theinsurance premiums to reduce, waive, or suspend the insurance premiumsin response to a determination of a leave.
 8. A method of processingdata in connection with an insurance premium adjustment program, themethod comprising: receiving via a communication device according to apre-determined schedule an eligibility data file including data relatingto individuals employed by an employer; transmitting to a computersystem of the employer via the communication device a bill file based onthe eligibility file, the bill file including data indicative of payrolldeductions to be made from individual payroll amounts to fund insurancepremiums for each of the individuals covered by an insurance plan;receiving from the employer computer system via the communication devicea remit file, the remit file including data indicative of the payrolldeductions actually made from the individual payroll amounts to fund theinsurance premiums for each of the individuals covered by an insuranceplan and leave status data for each of the individuals; determining, bya computer and responsive to receipt of the remit file, which of theindividuals are on a leave, the determination made based on averification of whether an insurance payment has been made to theindividuals for whom the leave status data is indicative of theindividual being on the leave; adjusting, by the computer and responsiveto a determination of disability, data indicative of the insurancepremiums associated with the insurance plan covering the individualsdetermined to be on the leave; transmitting to the employer computersystem via the communication device a payroll deduction modificationrequest for the individuals determined to be on the leave.
 9. The methodof claim 8, wherein the leave comprises a disability leave.
 10. Themethod of claim 9, wherein adjusting data indicative of premiumscomprises adjusting the data based on whether the disability leave is ashort-term disability leave or a long-term disability leave.
 11. Themethod of claim 8, wherein the leave comprises a maternity leave, apaternity leave, a hospital confinement leave, or a rehabilitationfacility leave.
 12. The method of claim 8, wherein the leave isassociated with a specific injury.
 13. The method of claim 8, furthercomprising terminating by the computer adjustment of the data indicativeof the insurance premiums for an individual when the eligibility datafile indicates that employment of the individual has been terminated.14. The method of claim 8, further comprising adjusting by the computerthe data indicative of the insurance premiums to reduce, waive, orsuspend the insurance premiums in response to a determination of aleave.
 15. A computer system for processing data relating to insurancepolicies, the system comprising: a data storage device storing datarelating to a plurality of personal insurance plans that coverindividuals; a communication device configured to send and receive datato a computer system of an employer having individuals employed by theemployer who are covered by at least one of the plurality of personalinsurance plans; a processor in communication with the data storagedevice and the communication device; and a non-transitory storage mediumin communication with the processor and storing program instructions,the processor operative with the program instructions to: receive viathe communication device according to a pre-determined schedule aneligibility data file including data relating to the individualsemployed by the employer; transmit to the employer computer system viathe communication device a bill file based on the eligibility file, thebill file including data indicative of payroll deductions to be madefrom individual pay to fund an insurance premium for each of theindividuals covered by the insurance plan; receive from the employer viathe communication device a remit file, the remit file including dataindicative of the payroll deductions actually made from the individualpay to fund the insurance premium for each of the individuals covered byan insurance plan and leave status data for each of the individuals;determine, responsive to receipt of the remit file, which of theindividuals are on a leave, the determination made based on averification of whether an insurance payment has been made to theindividuals for whom the leave status data is indicative of theindividual being on the leave; adjust, responsive to a determination ofdisability, data in the data storage device indicative of at least oneattribute of the personal insurance plans in response to thedetermination of which of the individuals are on the leave; and storethe adjusted data indicative of the insurance premiums in the datastorage device.
 16. The computer system of claim 15, wherein the dataindicative of at least one attribute comprises one of data indicative ofa premium payable for the insurance plans, data indicative of a policyliability limit, and data indicative of a deductible.
 17. The computersystem of claim 15, wherein the data indicative of at least oneattribute comprises data indicative of a premium payable for theinsurance plans, the leave comprises a disability leave, and adjustingdata in the storage device comprises adjusting the data indicative ofthe premium based on whether the disability leave is a short-termdisability leave or a long-term disability leave.
 18. The computersystem of claim 15, wherein the leave comprises one of a maternityleave, a paternity leave, a hospital confinement leave, a rehabilitationfacility leave, and a leave associated with a specific injury.
 19. Thecomputer system of claim 15, wherein the processor is further operativewith the program instructions to terminate adjustment of the dataindicative of the insurance premiums for an individual when theeligibility data file indicates that employment of the individual hasbeen terminated.
 20. The computer system of claim 15, wherein theprocessor is further operative with the program instructions to adjustthe data indicative of the insurance premiums to reduce, waive, orsuspend the insurance premiums in response to a determination of aleave.